Why Do We Have a Medicaid Program?
By Alieta Eck, M.D.
A Star Ledger headline reads: “ObamaCare fuels applicant boom for NJ Medicaid—Advocate hails 35% increase in October.” Almost 22,000 new applications were filed in October, up from 16,000 in September. Is this a triumph? Was a 990-page law needed to accomplish this? The taxpayers will have to fork over $5,000 per applicant to a Medicaid HMO—that’s $110 million—and what will the patients get?
I am a physician who volunteers at the Zarephath Health Center, a non-government charity clinic in central NJ, where volunteers care for the poor and uninsured. We see Medicaid patients who cannot find a Medicaid doctor. The other day I saw a 35-year-old mother with severe asthma. She is on Medicaid and had gone to the emergency room a few days earlier. She was instructed to find a physician for follow-up treatment. Unable to find a doctor who takes Medicaid, she was welcomed at our clinic. I saw her, spent time hearing her story, and was happy to give her prescriptions to keep her asthma in check.
The next day she returned with the odd complaint that no pharmacy would fill her prescriptions. Since I had not enrolled as a “non-billing Medicaid provider,” the pharmacies were told they would not be paid if they filled my prescriptions. I have a license, am board certified in internal medicine, and pay each year to keep my controlled-substances licenses updated, so why would they not honor my prescriptions?
When the patient called the Medicaid office, they instructed her to go back to the emergency room to get her prescriptions rewritten there—presumably copied by a physician enrolled in the program. Why would the Medicaid program deny her the medicines she needed? One would think they would appreciate the fact that a doctor was willing to see and care for her without costing the system anything. But apparently this is not how a bloated bureaucracy works.
Another Medicaid patient, a single mother of two, came complaining of abdominal pain. This has been going on for three months, and she has been to the emergency room several times. On the first visit they did an abdominal ultrasound and saw gallstones. But because her liver enzymes were not elevated and this was not considered an emergency, she was sent home and instructed to find a surgeon to take her gallbladder out. After making many phone calls, she never made it past the receptionist, as no surgeon takes Medicaid. Here is why. A dishwasher repairman is paid more than a doctor who takes Medicaid. Yet the doctor could be held liable for hundreds of thousands of dollars if there is a bad outcome.
Happily, someone told this patient about our clinic. We contacted a surgeon who said he would be pleased to help. The clinic will be able to pay him a fair fee without the exhaustive paperwork and claim forms. The patient will be treated like a VIP.
So why do we have Medicaid? Is it about providing care, or about setting up a large bureaucracy to make it appear that the poor are getting care?
We do not need Medicaid. We do not need ObamaCare. In a sensible world, there would be three layers to provide optimal care at reasonable cost: 1) direct payment for routine care; 2) low-priced, high-deductible health insurance for major medical events; and 3) real non-government charity for those who cannot afford either.
Come let us reason together and throw off the government bureaucracy. Politicians ought not take credit for what doctors, nurses, hospitals, and communities do. In actuality, President Obama must take ownership of his failure and take the blame for fleecing the taxpayers to erect barriers to care.
The sooner we repeal ObamaCare, the better.
Dr. Alieta Eck, MD, (New Jersey), graduated from the Rutgers College of Pharmacy in NJ and the St. Louis School of Medicine in St. Louis, MO. She studied Internal Medicine at Robert Wood Johnson University Hospital in New Brunswick, NJ and has been in private practice with her husband, Dr. John Eck, MD in Piscataway, NJ since 1988. She has been involved in health care reform since residency and is convinced that the government is a poor provider of medical care. She testified before the Joint Economic Committee of the US Congress in 2004 about better ways to deliver health care in the United States. In 2003, she and her husband founded the Zarephath Health Center, a free clinic for the poor and uninsured that currently cares for 300-400 patients per month utilizing the donated services of volunteer physicians and nurses. Dr. Eck is a long time member of the Christian Medica l Dental Association and in 2009 joined the board (and is a former President) of the Association of American Physicians. In addition, she serves on the board of Christian Care Medi-Share, a faith based medical cost sharing Ministry. She is a member of Zarephath Christian Church and she and her husband have five children of which one is an ophthalmology resident in St. Louis in NJ. Dr. Eck ran in the Special Republican Primary for the US Senate from New Jersey in August, 2013, garnering 27,000 votes in a 2 month campaign. She is contemplating a second run in 2014.
but we now are into the third generation raised on the premise that “MotherGovernment” shall provide, everything, soup to nuts, cradle to grave.. Just vote lib, squawk, and get your goodies, period.. Appreciate your practicality, rationality, and service, but believe we will never fix this mess that used to be the best system/ country in the world!..
A big part of the problem is that New Jersey’s reimbursement rates to doctors are close to the lowest in the country.
Good article on the subject at this link.
http://www.nj.com/politics/index.ssf/2013/08/nj_doctors_least_likely_to_accept_new_medicaid_patients_survey_says.html
Every state has Medicaid since Arizona joined in 1982. So all those Tea Party Governors have a lot of explaining to do since any state can withdraw from the Medicaid program via legislative action.
and thanks to the Republican leadership, who is completely out of touch, we will add millions of illegals to this program with amnesty.
Reimbursement rates are a tangential deflection. This clinic was operating free. The account of this physician is an all-too-typical picture of bureaucracy run completely wild.
Where are our legislators to prevent this sort of totally counterproductive lunacy?
[…] for the NJ GOP. Republicans would be foolish to let the nomination go to someone like Dr. Alieta Eck to take one for the team. Eck is a wonderful woman with important and workable ideas on how to […]